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Outbreak of Autism (pg. 3)
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| NeoPhono |
| quote: | Originally posted by Moral Hazard
The test is crap. A) a series of questions is insufficient to diagnose a disorder of this type, and B) if you can complete the tests then, even if you are autistic, you're functioning at a sufficiently high level as to make a diagnosis of autism irrelavent. |
While I do agree that a simple online test will not definitively tell you if you have a form of autistic spectrum disorder, "real" diagnosis is done in a fairly subjective manner based on social interaction as well as other outward signs of ASD. There really is no lab test for autism. Also, we have to consider that "autism" today is a spectrum of disorders, ranging from those who are virtually unaffected to those with severe (classic) autism.
From the American Academy of Pediatrics:
| quote: | | The pediatrician is faced with the challenging task of suspecting an ASD diagnosis as early as possible and implementing a timely treatment plan to achieve the best outcome for the child and family. Early diagnosis of ASD is challenging in the context of primary care visits, because there is no pathognomonic sign or laboratory test to detect it. Thus, the physician must make the diagnosis on the basis of the presence or absence of a constellation of symptoms. ASD is a phenomenologic rather than an etiologic disorder (eg, trisomy 21 in Down syndrome), making the diagnosis more challenging. Pediatricians must rely on parent report, clinical judgment, and the ability to recognize criteria-based behaviors that define ASD. |
Here's the actual diagnostic criteria (autism) from DSM-IV:
| quote: | A. A total of six (or more) items from (1), (2), and (3), with at least two from (1), and one each from (2) and (3).
1. Qualitative impairment in social interaction, as manifested by at least two of the following:
a. marked impairment in the use of multiple nonverbal behaviours such as eye-to-eye gaze, facial expression, body postures, and gestures, to regulate social interaction.
b. failure to develop peer relationships appropriate to developmental level.
c. a lack of spontaneous seeking to share enjoyment, interests or achievments with other people eg: by a lack of showing, bringing or pointing out objects of interest.
d. lack of social or emotional reciprocity.
2. Qualitative impairments in communication as manifested by at least one of the following:
a. delay in, or total lack of, the development of spoken language not accompanied by an attempt to compensate through alternative modes of communication such as gesture or mime.
b. in individuals with adequate speech, marked impairment in the ability to initiate or sustain a conversation with others.
c. lack of varied, spontaneous, make-believe play or social imitative play appropriate to developmental level.
3. Restricted, repetitive and stereotyped patterns of behaviour, interests and activities, as manifested by at least one of the following:
a. encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus.
b. apparently inflexible adherence to specific nonfunctional routines or rituals.
c. stereotyped and repetitive motor mannerisms eg: hand or finger flapping or twisting, or complex whole-body movements.
d. persistent preoccupation with parts of objects.
B. Delays or abnormal functioning in at least one of the following areas, with onset prior to age 3 years:
1. social interaction
2. language as used in social communication
3. symbolic or imaginative play.
C. The disturbance is not better accounted for by Rett's Disorder or Childhood Disintegrative Disorder.
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Asperger's is even more subjective (in my opinion);
| quote: | A. Qualitative impairment in social interaction, as manifested by at least two of the following:
1) marked impairment in the use of multiple nonverbal behaviours such as eye-to-eye gaze, facial expression, body postures, and gestures to regulate social interaction;
2) failure to develop peer relationships appropriate to developmental level;
3) a lack of spontaneous seeking to share enjoyment, interests or achievments with other people (eg: by a lack of showing, bringing, or pointing out objects of interest to other people);
4) lack of social or emotional reciprocity.
B. Restricted repetitive and stereotyped patterns of behaviour, interests, and activities, as manifested by at least one of the following:
1) encompassing preoccupation with one or more stereotyped and restricted patterns of interest that is abnormal either in intensity or focus;
2) apparently inflexible adherence to specific, nonfunctional routines or rituals;
3) stereotyped and repetitive motor mannerisms (eg: hand or finger flapping or twisting, or complex whole-body movements);
4) persistent preoccupation with parts of objects
C. The disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning.
D. There is no clinically significant general delay in language (eg: single words used by age 2 years, communicative phrases used by age 3 years).
E. There is no clinically significant delay in cognitive development or in the development of age-appropriate self-help skills, adaptive behaviour (other than social interaction), and curiosity about the environment in childhood.
F. Criteria are not met for another specific Pervasive Developmental Disorder, or Schizophrenia. |
I guess what I'm trying to say is that autism is a wide range of disorders that are diagnosed by outward function, not by any sort of invasive diagnostic procedure. In that regard, those with higher functioning autism (Asperger's, etc.) fall into the same diagnosing category as those with depression or ADHD. There is no routine lab test for depression or ADHD, and there isn't one for autism.
I don't mean to downplay ASD, as I have worked with individuals who were obviously impaired by it. However, and to put in bluntly, ASD is the new ADHD is the new depression. In my opinion it is grossly overdiagnosed due to a broadening of its definition, public attention, need to explain perceived abnormalities by medical means and cultural changes. |
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| Moral Hazard |
You do realize that all of those sources cite the same study, right?
I have to admit, I was not aware of this Ireali study. I'd be interested to know whether or not these results have been replicated by other studies; however, I'll accept that there is a possibility that father's age effects autism rates. |
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| Moral Hazard |
| quote: | Originally posted by NeoPhono
In my opinion it is grossly overdiagnosed due to a broadening of its definition, public attention, need to explain perceived abnormalities by medical means and cultural changes. |
I think this is the point I was trying to get at earlier. |
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| nchs09 |
| quote: | Originally posted by Moral Hazard
You do realize that all of those sources cite the same study, right?
I have to admit, I was not aware of this Ireali study. I'd be interested to know whether or not these results have been replicated by other studies; however, I'll accept that there is a possibility that father's age effects autism rates. |
i did not, i apologize, but i have read a couple of other published studies that find the same thing. tried to look them up on pscyinfo but i cant seem to find them... will try later. |
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| DJ Shibby |
| quote: | Originally posted by Renegade
I wouldn't be so sure about that. I don't think that "bad parenting" in and of itself can directly cause autism (there is a genetic cause, most likely: can't find any stats at the moment, but I can remember reading that caucasian Americans are far more likely to be autistic than Americans of other races) but I think there's a case that can be made for "bad parenting" either potentiating autism epigenetically or at least vastly exacerbating the problem.
There's a psychologist called Stanley Greenspan who deals primarily with autistic children in his work and he wrote a book about the origin of human consciousness - The First Idea - which discusses the nature of austism at length. Basically, Greenspan believes that higher brain functions (language, reason, impulse control etc.) are not completely innate but are rather developed during childhood through "co-reciprocated emotional interaction" with parents and other people. Children that are either denied or incapable of emotional interaction will grow up stilted not just emotionally, but intellectually as well. If children with a predisposition to autism can be identified early and be made, with the right therapy, to learn to associate emotions with - at first - basic actions and words and - later on - with more complex forms of social interaction, then the worst symptoms can be avoided. The real point in regards to this discussion, though, is that he finds a correlation between what he calls "multiproblem families" (make of that what you will) and the severity of the autistic child's symptoms and prospects for recovery.
If this is all accurate, then bad parenting won't cause autism, but it can certainly make it a more severe problem. |
Though possible, I'd say it's more likely that our horrendous diets, chemical consumption (both in foods, products, and in the air), and maybe even recreational habits (smoking, caffeine, alcohol?) would play a greater role potentiating these sort of genetic disorders. |
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| venomX |
| quote: | Originally posted by DJ Shibby
Though possible, I'd say it's more likely that our horrendous diets, chemical consumption (both in foods, products, and in the air), and maybe even recreational habits (smoking, caffeine, alcohol?) would play a greater role potentiating these sort of genetic disorders. |
Proof? I think we've substantiated quite well the suggestion that it is far more likely to be other less exciting things potentianting these genetic disorders. After all, most of them have been around for ages (as have smoking, caffeine and alcohol of course). |
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| DJ Shibby |
| quote: | Originally posted by venomX
Proof? I think we've substantiated quite well the suggestion that it is far more likely to be other less exciting things potentianting these genetic disorders. After all, most of them have been around for ages (as have smoking, caffeine and alcohol of course). |
No proof obviously, just speculation... and the recreational example would be the weakest example, while the new developments of novel chemicals would be the strongest. But still, we don't know the answer, and I was just ruminating. =) |
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| venomX |
| quote: | Originally posted by DJ Shibby
No proof obviously, just speculation... and the recreational example would be the weakest example, while the new developments of novel chemicals would be the strongest. But still, we don't know the answer, and I was just ruminating. =) |
Fair enough. I think there should be more testing of novel chemicals. Sometimes I think industries and governments get too caught up in the potential benefits of some technologies and not enough testing is done. It is irresponsible considering the amount of testing that can be done now in computer simulated environments. We should be wary of novel combinations and compounds. The problem is always how to balance the potential benefits with the potential risks. It is definitely a thorny issue. |
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| NeoPhono |
| quote: | Originally posted by venomX
Fair enough. I think there should be more testing of novel chemicals. Sometimes I think industries and governments get too caught up in the potential benefits of some technologies and not enough testing is done. It is irresponsible considering the amount of testing that can be done now in computer simulated environments. We should be wary of novel combinations and compounds. The problem is always how to balance the potential benefits with the potential risks. It is definitely a thorny issue. |
But...it's easy to check the immediate impact of a new substance, much harder to know what an affect it will have 30 or 40 years down the road, much less to how it might impact future offspring. I'm not saying that we shouldn't make the process as safe as possible, but there will always be limits to how well we really know what something will or will not do.
I see it as similar to drug testing. There are what, 6.5 billion people on the earth? You do years of testing on upwards of thousands of people. At the end of the testing period you release it as a "safe" drug. But just because no one in your test group of a couple hundred or thousand people didn't have an adverse reaction doesn't mean no one out of the 6.5 billion people on this earth, each with unique physiologies, won't.
I don't really foresee any way in which we could ever deem a compound completely, 100% safe. We should try our best, but I can't even see complex computer model being able to account for all the variables since we don't even know what they might be. In the end I guess it's just a risk we'll have to take. Do we want the newest innovations as quickly as possible, or do we want to "ensure" safety by sticking with older products or waiting decades or centuries to fully test them? |
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| venomX |
| quote: | Originally posted by NeoPhono
But...it's easy to check the immediate impact of a new substance, much harder to know what an affect it will have 30 or 40 years down the road, much less to how it might impact future offspring. I'm not saying that we shouldn't make the process as safe as possible, but there will always be limits to how well we really know what something will or will not do.
I see it as similar to drug testing. There are what, 6.5 billion people on the earth? You do years of testing on upwards of thousands of people. At the end of the testing period you release it as a "safe" drug. But just because no one in your test group of a couple hundred or thousand people didn't have an adverse reaction doesn't mean no one out of the 6.5 billion people on this earth, each with unique physiologies, won't.
I don't really foresee any way in which we could ever deem a compound completely, 100% safe. We should try our best, but I can't even see complex computer model being able to account for all the variables since we don't even know what they might be. In the end I guess it's just a risk we'll have to take. Do we want the newest innovations as quickly as possible, or do we want to "ensure" safety by sticking with older products or waiting decades or centuries to fully test them? |
I completely agree. My post was a bit short so it might have been ambiguous, but I basically agree with your opinion. I didn't mean to come across as saying that we shouldn't use new substances because they are potentially dangerous, but just that we should exercise caution. |
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| NeoPhono |
| quote: | Originally posted by venomX
I completely agree. My post was a bit short so it might have been ambiguous, but I basically agree with your opinion. I didn't mean to come across as saying that we shouldn't use new substances because they are potentially dangerous, but just that we should exercise caution. |
That's cool. That's actually what I figured after re-reading what you'd written. |
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| DJ Shibby |
| quote: | Originally posted by venomX
Fair enough. I think there should be more testing of novel chemicals. Sometimes I think industries and governments get too caught up in the potential benefits of some technologies and not enough testing is done. It is irresponsible considering the amount of testing that can be done now in computer simulated environments. We should be wary of novel combinations and compounds. The problem is always how to balance the potential benefits with the potential risks. It is definitely a thorny issue. |
Hm, perhaps, as long as the testing does not impede the development and access to the chemical.
The government over here has a lot of stringent limits on testing of chemicals, and its very tied into FDA money games and power pyramids, which is part of the reason why there's so little data available on so many obvious compounds. There are many very common herbs that have been used for thousands of years, for example, which have amazing properties and amines or other structures, which are unexplained and unexplored.
There's also a veritable infinity of potential atomic soups that could be created, and we don't really see a reason why. For example, the phenol ring sometimes improves awareness, and sometimes fails to have any activity whatsoever. So it's really not plausible for computer models to do anything more than guesstimate the potential visual displays of a possible chemical, while at the same time most of our useful synthesis routes are either extremely straightforward and hundreds of years old, or involve biosynthesis, which is largely outside our realm of understanding at the moment. |
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